Ajani Jaffer
Department of Gastrointestinal Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4009, USA.
Cancer. 2006 Jul 15;107(2):221-31. doi: 10.1002/cncr.21986.
Capecitabine is a novel, orally administered fluoropyrimidine carbamate that has been approved for adjuvant treatment in patients with Stage III colon cancer, first-line metastatic colorectal cancer, and metastatic breast cancer, both as a single agent (for patients who are resistant to paclitaxel and anthracyclines) and in combination with docetaxel (after failure on anthracycline-based therapy). Capecitabine is being investigated in Phase I and II trials for the treatment of gastric, gastroesophageal, and esophageal cancers, primarily in the first-line metastatic setting but also in the adjuvant setting. The MEDLINE data base was searched for English-language clinical trials that were published from 1996 through October 2005 along with relevant abstracts that were presented at the American Society of Clinical Oncology and at meetings of the European Cancer Conference and the European Society of Medical Oncology. The most frequently investigated combinations were capecitabine with docetaxel, paclitaxel, cisplatin, or oxaliplatin, and capecitabine also has been combined with irinotecan. These therapies have yielded efficacy data that compare favorably with data from Phase III trials of parenteral 5-fluorouracil (5-FU) in the first-line metastatic setting, and they mostly are well tolerated. Capecitabine, when combined in doses <1250 mg/m(2) twice daily, consistently resulted in a lower frequency of Grade 3 or 4 toxic effects. Capecitabine, as a representative of oral fluoropymidine, is a promising agent in gastroesophageal cancers. Although some Phase III trials are completed, additional Phase III trials of capecitabine-based combinations that compare its efficacy and safety with parenteral 5-FU-based combinations, in both first-line metastatic and adjuvant settings, would be important.
卡培他滨是一种新型的口服氟嘧啶氨基甲酸酯，已被批准用于III期结肠癌、一线转移性结直肠癌和转移性乳腺癌患者的辅助治疗，既可以作为单一药物（用于对紫杉醇和蒽环类药物耐药的患者），也可以与多西他赛联合使用（在基于蒽环类药物的治疗失败后）。卡培他滨正在进行I期和II期试验，用于治疗胃癌、胃食管癌和食管癌，主要用于一线转移性情况，但也用于辅助治疗。检索MEDLINE数据库中1996年至2005年10月发表的英文临床试验以及在美国临床肿瘤学会、欧洲癌症会议和欧洲医学肿瘤学会会议上发表的相关摘要。研究最频繁的联合用药是卡培他滨与多西他赛、紫杉醇、顺铂或奥沙利铂，卡培他滨也与伊立替康联合使用。这些疗法产生的疗效数据与一线转移性情况下静脉注射5-氟尿嘧啶（5-FU）的III期试验数据相比具有优势，并且它们大多耐受性良好。当卡培他滨以每日两次剂量<1250 mg/m²联合使用时，3级或4级毒性反应的发生率始终较低。卡培他滨作为口服氟嘧啶的代表，在胃食管癌中是一种有前景的药物。尽管一些III期试验已经完成，但在一线转移性和辅助治疗中，额外进行基于卡培他滨的联合用药的III期试验，将其疗效和安全性与基于静脉注射5-FU的联合用药进行比较，将是很重要的。
